Individual
KANIEL REVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8755 CARTER RD APT 34, FREELAND, MI 48623-8768
(989) 213-2903
Mailing address
8755 CARTER RD APT 34, FREELAND, MI 48623-8768
(989) 213-2903
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
MI
Other
Enumeration date
04/24/2016
Last updated
04/24/2016
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